Overcoming Compassion Fatigue in Ministry, Part 1

I was describing the emotional toll that ministry takes on pastors while they are encouraging and counseling people who experience especially difficult times. The person I was speaking to had received training for this very thing as an emergency medical technician. He said, “That’s compassion fatigue.”

I had never heard the term and was not familiar with the concept. When he explained it, lights came on. People in helping professions, including medical personnel, social workers, and clergy, are repeatedly exposed to deep and complicated problems in the course of their work. They can develop a mindset of detachment that reflects diminished compassion for the person they are helping. When I heard this description I recognized it in my own experience.

I also recognized another phenomenon he described to me – vicarious trauma, or secondary trauma. This occurs when a helper walks through a traumatic experience with someone, such as a church member or counselee, and bears much of the impact that comes with that traumatic scenario. For example, a man’s wife leaves him for another man, or another woman. Or a young couple is killed in a tragic accident, leaving an orphaned child. Or a woman addicted to drugs is destroying her family. The pastor ends up pouring time and energy – physical, emotional, and spiritual – into these situations. These life-altering, cataclysmic scenarios are on his mind day and night and are the subject of many conversations with his spouse. Bearing this weight takes a toll. The secondary trauma puts a strain on him and can lead to compassion fatigue.

The primary problem with compassion fatigue is losing the ability to care. Pastoral care is not only a set of practices. It requires an attitude of genuine care for individuals. We are commanded to love others. This strongly implies that we are genuinely concerned for their well-being. Compassion is the ability to feel with someone who is hurting. If we become desensitized to the point of detachment, the element of love is removed. We are in danger of performing pastoral work in a clinical, professional, or mechanical manner.

A secondary effect of compassion fatigue is we feel guilty about it, which can turn into a downward spiral of discouragement. A pastor one day realizes he has lost his capacity to feel people’s burdens with them. He catches himself listening to a church member unburden himself and wishing he could be somewhere else. He drags himself to another pastoral visit. He dreads another counseling appointment. He can’t bring himself to write down another church member’s prayer request and intercede for them at the throne of grace.

He knows he should be compelled by love and find joy in serving others. He feels guilty for his reluctance and becomes discouraged about ministry when he feels the urge to run away from hurting people rather than move toward them.

Origin and Definition of the Term

Dr. Charles Figley is the Tulane University Distinguished Chair in Disaster Mental Health and Associate Dean for Research and Director of the Traumatology Institute. He authored Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Figley has published numerous additional articles and anthology chapters on this and related subjects.

Figley defines compassion fatigue as

a state of tension and preoccupation with the traumatized patients by re-experiencing the traumatic events … It is a function of being witness to the suffering of others.¹

The term was first used in a study of burnout in nurses conducted in 1992. A description of this study states,

Multiple environmental stressors, such as expanding workload and long hours, coupled with the need to respond to complex patient needs, including pain, traumatic injury, and emotional distress, resulted in nurses feeling tired, depressed, angry, ineffective, apathetic, and detached.

The description goes on to say,

Nurses are particularly vulnerable to compassion fatigue. They often enter the lives of others at very critical junctures and become partners, rather than observers, in patients’ healthcare journeys. Acute care nurses in particular often develop empathic engagement with patients and families. This, coupled with their experience of cumulative grief, positions them at the epicenter of an environment often characterized by sadness and loss. Nurses are frequently enmeshed in existential issues surrounding life and death.²

Three faculty members of the University of Ulster in Northern Ireland published a study on compassion fatigue among clergy. Elements of the study address the impact on clergy of ministering to people affected by the 9/11 attacks. The effect included “significant levels of compassion fatigue.” They warned,

There is a price being paid as a result of vicarious involvement within the course of the daily pastoral ministry that entails seemingly less major events … but which involves daily exposure to the pain of others.³

Pastors experience mini-9/11s on a regular basis. The call that sends you to the emergency room to comfort a family in shock, the family breakup, runaway teenager, adultery exposed – you carry the pain of others in your heart and feel the anguish in a similar way as they do. And this is multiplied times the number of people you have in your church.

The Biblical Counseling Center, located in the Chicago area, says on this topic,

In clinical settings, compassion fatigue is sometimes referred to as ‘secondary trauma’ or ‘vicarious traumatization.’ It may also be considered similar to a type of PTSD that affects those who provide soul care to trauma victims.⁴

The American Institute of Stress defines compassion fatigue as “the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.”⁵ One counselor says, “Generally, it is caused when one has become so involved in providing care to others that they become emotionally and spiritually exhausted”⁶ Compassion fatigue is sometimes described as the cost of caring.

Manifestations of Compassion Fatigue

There are numerous lists. Some symptoms sound like normal human struggles, or even fleshly responses to people and situations. However if these are a pattern, especially several of them together, and become more pronounced over a period of time, possibly in a way that is noticed by people who know you, you may want to consider that compassion fatigue is a factor. I’ve selected some of the more prominent, noticeable symptoms:

• Physical – Fatigue, lack of endurance, loss of strength, difficulty sleeping, somatic problems (headaches, colds, ulcers)

• Emotional – Irritability, anger, anxiety, depression, apathy, cynicism, becoming jaded, hardened to people and their problems, discouragement, feeling overwhelmed, attitude of hopelessness

• Behavioral – Aggression, callousness, pessimism, defensiveness, loss of interest in behaviors once enjoyed, withdrawal from family or friends

• Spiritual – Decrease in discernment, disinterest in introspection, lack of spiritual awareness, poor judgment

• Intellectual – Boredom, disorderliness, weakened attention to detail

• Work-Related – Absenteeism, tardiness, avoidance of intense patient situations, impersonal communication ⁷

The bottom line is, “You can’t hear other people’s pain without being affected by it. If you aren’t affected, that’s a true sign of compassion fatigue.”⁸